I currently receive IVIG monthly for both my immune deficiency and my neuropathy. I have also received plasmapheresis, but it was for my APS (antiphospholipid syndrome---an autoimmune based blood clotting disorder). I have honestly not heard of this being used for SFN or POTS unless it includes complete autonomic failure. It is not only a costly procedure, but one that has considerable risks. It also doens't last long and has to be repeated. I was recieving it every other day, so that is not conducive for long term treatment. It is typically saved for life threatening conditions.

The IVIG would be better to try first, in my opinion. It has better documented succes for SFN and POTS and can bed done monthly. The Plasma exchange has to be done more frequently, may not last as long, and has more risks and side-effects than IVIG.

If you haven't tried IVIG then that should really come first (after steroids and immune supression). If unsuccessful and your condition worsens to critical levels, then plasma exchange should be considered.

Hope this helps.